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Universal Family-Focused Interventions in Alcohol-Use Disorder Prevention: Cost-Effectiveness and Cost-Benefit Analyses of Two Interventions

Richard L. Spoth, Max Guyll, Susan X. Day

Objective: Epidemiologic research suggests that significant public health benefits can accrue from preventive interventions that delay the initiation of youth alcohol use. This analysis compares the cost effectiveness of two interventions designed for general population families of adolescents. It also conservatively estimates their benefit-cost ratios and net benefits. Method: Cost-effectiveness and cost-benefit analyses were performed on data from a longitudinal prevention trial with families of sixth graders from 33 rural schools in a midwestern state. Schools were blocked on size and proportion of lower income families and then randomly assigned either to one of two interventions or to a control condition. Interventions included the Iowa Strengthening Families Program (ISFP), a seven-session intervention with parents and students together, and Preparing for the Drug Free Years (PDFY), a five-session intervention focusing primarily on parents. Results: Conservative estimates for the ISFP intervention were a cost-effectiveness figure of $12,459 per case prevented, a benefit-cost ratio of $9.60 per $1 invested, and a net benefit of $5,923 per family. For PDFY, estimates were a cost effectiveness of $20,439 per case prevented, a benefit-cost ratio of $5.85 per $1 invested, and a net benefit of $2,697 per family. Conclusions: Family skills training interventions designed for general populations have the potential to delay the onset of alcohol use and may avoid substantial costs to society at a proportionally small intervention cost. Economic analysis of such interventions is a largely unexplored area that could provide valuable guidance in forming public policy. (J. Stud. Alcohol 63: 219-228, 2002)